Today’s food and love hack is about what’s going on in your brain. Who’s in there, what’s talking to you, and how do you respond to it?

The hack:

Re-think your brain space.

There are a number of different ways we can think about what is happening in our brains. One particularly helpful one, in my opinion, is conceiving of ourselves, our true selves, as separate from our negativity.

That negative self-talking voice, that hurt voice, that doubtful voice… it is not genuinely you. It just plain isn’t. It is instead theexternal worldand all of the damage the external world has inflicted on you over time. So there is more than just one player in your brain. There is you, and then there’s the external world creating nasty and hurt voices in your head.

What is truly you, instead, is that pulsating little pinprick of color and vibrancy bouncing around–I’d daresay call it a soul–that negativity impinges upon. And sometimes squashes.

Ack.

So it’s not just you in there: it’s you, plus all of the bad things that have happened to you. And while these events have certainly shaped you and made you in part who you are today, for both good and for bad, these parts are not necessary, they are not inevitable and they are not permanent.

Your negative thoughts are demons with claws in your heart. They are happening to you. And yetthey are not your fault. You cannot help that your brain is being attacked. What is in your control, however, is your reaction to them. How do you tame the demons? What is the best way to navigate your crowded brainspace?

The way to do so is to acknowledge that these thoughts, totally derived from the external world, are creating chatter in your brain, and making it hard for you to be your true self. Certainly you know what this is like. You want to dance with abandon, but you’re nervous about what people’ll think. You want to hit on that woman, but you remember the way it felt when the last woman you were with told you you were unattractive. You want to be free, but how can you if you feel so self-conscious about your dress size? Old wounds and external pressures make it hard to be ourselves.

But when you acknowledge that your negative self-talk, say, thinking that you do not deserve to be loved, or that your loved ones are going to leave you, or that you’re simply not sexy enough, is not you, that makes it all the easier to tell it to go fuck itself. This is a bit easier said than done, but if you can parse your brain, and go through all of your thoughts, and think about where the negativity is stemming from, then you can start spotting areas in your thought pattern where you get to be the most true to yourself, and where your pain is taking over.

In the cases when your pain is taking over, you have some options. You can brush it off– tell it to go away, you’re tired of it, you’re done. You can also throw love on it. Much like the anxiety we talked about last time, you can try to smother it with kindness. Or you can put all of your weight behind your own shoulders and push ’em up, daring yourself to be bolder than your baggage. All of these things come easier with time. They are not easy. But they are muscles, and powerful.

The task:

Think about all of the different voices in your head, and where they are coming from. You know that the pain in your life has obviously come from the outside world, but it is important to now internalize the idea that it is not genuinely your thought.

In turn, think about what you, you as that little pinprick of joy I was talking about, what would your essence always be thinking? What would you, without defensiveness and negative self-talk and pain do? What would you think? Feel? How would you react to situations differently?

The more you flush out these differences, the more you can move forward seeing their divergent paths in your life. In any given situation, you can see where each would lead you. Knowing that one is true to you, and one is external, helps enormously. Forgiving your pain helps. And siding with yourself, gradually and increasingly throughout time, lifts your spirit and helps you shed the weight of the world.

I have been receiving a fair number of e-mails and messages about the Gender Differences in Fat Deposition post over at Mark Sisson’s site. Can I throw my hands up and say “ah ha! We did it! The giants are talking about sex differences. Now I can retire and move on to different projects”? Yeah, maybe a little bit. But I won’t. I’ve become too addicted to this community and work. Which, of course, needs all of the advocates and passion we can throw at it.

Women burn fat differently than men. Upper body fat goes first, while lower body fat tends to stay put. Except during pregnancy and lactation, when the lower body begins to give up lower fat stores far more readily. Interestingly (and not by coincidence), women tend to preferentially store the long chain omega-3 fatty acid DHA – the one that’s so important to the baby’s development during and pregnancy – in their thighs.

Mark also remarks in his post, much like I did in my estrogen post, that women tend to store fat around the hips buttocks and thighs, and this has been shown time and time again to be healthier than the typical male pattern of abdominal fat deposition. This is well known in the literature and encouraging for curvy women everywhere.

I have, however, been getting a lot of questions about fat deposition in the abdomen. When and why do women still store fat in their abdomens, even though they traditionally have more subcutaneous fat than men?

1) Women store fat in the abdomen during menopause.

Women store fat in their abdomens during menopause fairly frequently. This is because estrogen levels are dropping sharply. Many women supplement with bio-identical hormones, in fact, and see their weight gain / weight shift minimize. Another great way to mitigate this problem is to eat a diet consisting of whole foods, which will minimize insulin spiking that can also contribute to abdominal fat gain, and which will also keep hormone levels fairly well-balanced.

Menopausal women may also want to play around with soy if they are experiencing dramatic menopause symptoms. Please proceed with caution in that case, however. I wrote about how complicated soy is here.

2) Women store fat in the abdomen when they are stressed out.

Cortisol drives abdominal fat deposition. This comes from stress as well as from any loss of sleep quality that may have occurred as a result of stress.

Cortisol and insulin tend to run together, as well, which means that this point and the following point can be difficult to untangle.

3) Women store fat in the abdomen when they are insulin resistant.

Insulin resistant women experience more abdominal fat deposition than those who are insulin sensitive. Moreover, a woman at any single BMI can be insulin resistant, which means that thin women can have IR problems still and deposit fat in their abdomens. The results from one study are particularly striking:

” We found a strong negative relationship between central abdominal fat and whole-body insulin sensitivity, and nonoxidative glucose disposal, independent of total adiposity, family history of NIDDM, and past gestational diabetes. There was a large variation in insulin sensitivity, with a similar variation in central fat, even in those whose BMI was <25 kg/m2.”

4) Women store fat in the abdomen when they are particularly genetically primed to.

Some women naturally have more fat in their abdomens than other women do– that’s just how genetic rolls the dice. It’s okay, it really is. It does not mean you are unhealthy. Only blood tests might reveal that. Each woman has a different shape particular to her genetics and her history.

Have experiences with different kinds of fat? Fed up with hefty ab fat but non-existent ass-fat like Elissa? Have a hard time loving your stomach even though you totally should? Let me hear it in the comments!

Today we are going to kick off the Kick Ass Birth Control series by talking about America’s most popular method: the pill.

The thing is, the pill is so complicated and comes in so many different forms, it’ll have to be broken down.

This post focuses on how the pill works, and what this might mean for health and fertility. The next installment will cover all the various types of pills, explaining and weighing pros and cons of each.

In addition to the posts in this series, you can find more information on birth control in the book I wrote, available here.

And briefly, beforehand, the world’s quickest announcement: the T shirt contest has been closed! We got dozens of awesome designs. Beautiful, fierce, simple, explicit, exquisite… so thank you, thank you so much, all of you, for caring about and loving this community. So I am sitting on some ideas and going through sketches with my artistic pals. The T shirts and the giveaways will be revealed as soon as we have that done, definitely within the month. !

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The normal menstrual cycle and getting pregnant

In order to understand how birth control pills work, it is crucial to first understand the menstrual cycle.

In super brief:

The menstrual cycle is a complex interplay between hormones secreted from the pituitary gland, and the hormonal responses of the reproductive organs over the course of approximately one month.

In moderately brief:

In a normal menstrual cycle, FSH is secreted by the pituitary gland, which stimulates follicular development, then the ovaries respond with rising estrogen levels. These estrogens then trigger an FSH decrease and an luteinizing hormone (LH) spike, which induces ovulation, and then progesterone levels rise. Progesterone peaks and then falls, and the falling of progesterone triggers the shedding of the endometrium in blood flow during what we commonly call week 1. Then the cycle begins anew.

In details:

The first day of a menstrual cycle is the first day of bleeding. During this period, the lining of the uterus is shed. This bleeding constitutes the first 3-8 days of the first half of the menstrual cycle, which lasts about two weeks and is called the follicular phase.

During the follicular phase, levels of estrogen rise and make the lining of the uterus grow and thicken. Detecting elevated estrogen levels, the pituitary gland increases its production of follicle-stimulating hormone throughout the follicular phase. This hormone stimulates the growth of 3 to 30 follicles. Each follicle contains an egg. With time, the levels of FSH decrease, so only one of the follicles continues to grow. It produces estrogen, and other stimulated follicles break down.

Detecting this shift, the pituitary now releases luteinizing hormone. This makes the follicle bulge and rupture, releasing its egg. This is ovulation. During ovulation, testosterone, which is otherwise constantly produced at low levels by the ovaries, surges, and estrogen drops.

After ovulation comes the luteal phase. Here the ruptured follicle closes and forms the corpus luteum. This thickens the endometriums, which in turn produces progesterone. But if the egg is not fertilized within about two weeks, progesterone levels fall, which triggers shedding and bleeding. Here the cycle begins again. Cycles are generally “known” to be 28 days long, but the length of a regular, healthy cycle can vary from ~20 to ~35 days.

How a woman gets pregnant

A woman gets pregnant when a sperm is implanted in the egg in the dates immediately preceding, during and following ovulation (as much as a few days earlier if the sperm hang around long enough, and 1-2 days later, when the egg dies). When this is the case, progesterone levels never fall. Because progesterone levels never fall, menstruation never occurs. This is why missing periods or “being late” is often the first sign a woman guesses she may be pregnant.

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What birth control pills are

Birth control pills are streams of hormone supply.

They come in either a) progesterone-only forms, or in b) progesterone-estrogen combination pills.

They can be monophasic, diphasic, triphasic, or now quadriphasic, meaning that there can be a) a steady stream of a low dose, or b) a fluctuating amount of hormones. This fluctuating, cyclical type of pill is thought to approximate a more natural cycle.

Usually birth control pills are taken in monthly cycle, and they deliberately induce menstruation, though now some formulations last for up to three months.

When to take the pill

A woman takes a pill every single day for a given period of time, and usually at the exact same time. This is important, because the level of hormones in the blood must be sufficient at all times in order to prevent a cascade of hormones further down the line.

Think of it like this: if you are late in taking your progesterone pill, your pituitary gland might get excited and send an LH signal. You might later get the progesterone into your system, say 6 or 12 hours late, but by that time the LH has already been released, and ovulation has already occurred. It is supremely important to take the pills on time.

How it works

Progesterone-only pills were the first pills ever designed. The idea is simple, and the effect, profound.

Progesterone in the system– as we saw in the review of the normal menstrual cycle– prevents the release of FSH and LH in the brain. In sum, that means that when a woman takes a daily progesterone pill, FSH and LH do not get secreted. FSH and LH are responsible for ovulation taking place, so without them, the woman does not ovulate.

In greater detail, that means: in step 1) Progesterone inhibits FSH production. Step 2) Low FSH levels prevent estrogen levels from rising, and prevent development of the endometrium. 3) Estrogen maintains a baseline low, and that fact, coupled with the high levels of progesterone, prevent LH from being triggered. And finally, in 4) because there is no LH, no ovulation takes place. Because there is no ovulation, the woman does not get pregnant.

Combined oral contraceptives

Recently after the progesterone pill was developed, estrogen was added to several formulations to create the combined oral contraceptive. The reason estrogen was tacked on (a decade or so after the original development of the pill) was because doctors thought it would stabilize the endometrium and sort of prevent breakthrough bleeding. Which it did. What doctors found, however, was that the estrogen also helped prevent ovulation. This is important to take note of for women who suffer from estrogen dominance and are trying to conceive.

The effect of adding estrogen to pills, then, is to prevent breakthrough bleeding. It can also be helpful for women who struggle with low estrogen levels (often from low body fat or stress) or from high testosterone levels. This is because estrogen helps balance testosterone in the bloodstream. Women with PCOS, for this reason, are proscribed estrogen-containing pills much of the time if they are trying to manage their testosterone-dominant symptoms.

Other ways pills work

Birth control pills also have physiological effects that prevent pregnancy. Progesterone decreases the amount of and increases the viscocity (thickness) of cervical mucus. This makes it near impossible for sperm to penetrate through the cervix.

The timing of the pill

Most pills are designed to mimick as much as possible the natural menstrual cycle. The reason for this is not quite clear, and leans heavily on the psychological. When they were designing the pill several decades ago, doctors seemed to think women needed to menstruate regularly in order to feel normal or comfortable in their own skin. That has changed in recent years, though that bias remains somewhat strong.

This fact means that the most common pattern is for progesterone to be taken for 21 days, and then either a placebo or no pill for the next 7 days. By day 21 of the cycle, ovulation has already been inhibited long past. This means that progesterone can be dropped off by day 21 with no worry of ovulation taking place, while simultaneously being enough of a drop to induce menstruation.

Another model is to change the 21-7 day cycle to 24-4 days, which can shorten and lighten the periods.

It is also physiologically somewhat important to have a withdrawal bleed, since it is possible that the endometrium will build up too thick without menstruation, which can lead to certain physiological complications such as cancer. However, those occur on long time scales, and this effect varies widely depending on how much estrogen is in a woman’s system and how much her endometrium grows over time.

However, in general, the pill decreases endometrial thickening, so this is in fact a benefit of the pill–reducing the risk for this type and source of cancer– rather than a negative.

So is it necessary to have a withdrawal bleed every month?

No, in fact, it isn’t.

Some pills extend the cycle to three months long

Though the thing is, we can hardly call a three month long stasis a “cycle.” It isn’t. What happens in three-month long pills such as Seasonale is that progesterone continually inhibits LH and FSH without end. No menstruation or cyclic pattern occurs.

Finally after three months– a somewhat arbitrary number decided on by pill manufacturers and the medical community, a withdraw bleed is induced by taking a few placebo pills. In theory, you could just keep taking progesterone and not menstruate for as long as you desired. But again, because it is nice to “reset” and also to clear up the endometrium, especially if on a pill that contains estrogen, withdrawal bleeds should happen occasionally.

Positive effects of the pill?

Reduction in cancer risk of female-specific cancers–endometrial, ovarian, and colorectal.

If this is true, it is probably in my personal opinion because of the dampening effect progesterone has on estrogen, which itself plays a role in feeding tumors. However, other studies demonstrate increased breast cancer risk with pill consumption.

Increased vaginal lubrication?

Alleviation of PMS

Decreased Acne

Negative effects of the pill?

Increase in cancer risk (not yet known)

Weight gain

Decreased libido

Decreased vaginal lubrication

Acne

Depression

Psychological disturbances such as anxiety, insomnia, or rage

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Pill acclimatization and amenorrhea

Another affect of going on the pill is that the body might become overly-dependent upon it. Hormones run off of negative feedback loops. What this means is that detecting certain levels of a given hormone in the blood tells the appropriate glands to stop producing that hormone. This makes sense, right, in light of the fact that the body wants to maintain proper hormonal balance.

This has negative implications for women who supplement with estrogen or progesterone (ie, take the pill) during their reproductive years, however. Because the hormones are being eaten or injected into the bloodstream, the body often stops making them. And then after the pill, the body still does not make them. Some women might go several months or up to a year before they begin ovulating and menstruating again.

This is of course not usually the case. Most women are just fine off of the pill. Just as with the side effects. 60 percent of women report not having any side effects on the pill. Most of the rest have some side effects, but bear with them. Others find that the side effects are unbearable, and choose other fertility methods.

Why the pill has both positive and negative effects

Each woman’s body is different. This means that adding estrogen to the bloodstream might help her symptoms, but in other cases adding estrogen to the bloodstream could do a lot of harm. The same of course goes for progesterone. Adding these hormones to the bloodstream has the potential to either increase or decrease the levels above what is natural for a woman– and in fact it is almost certain that they will be differently balanced.

Upsetting the natural balance between estrogen and progesterone, as well as between those hormones and the rest of the sex hormones, particularly testosterone, can have serious effects on a woman. Estrogen and testosterone need to be specifically and well balanced in order for a woman to have a properly functioning sex drive. Estrogen and progesterone need to be well-balanced for clear skin. And so on and so forth. The list is long.

It is worth noting, moreover, that estrogen and progesterone act as “antagonists” to one another, meaning that progesterone has the power to reduce estrogen’s effects, and vice versa. This is partly why combination pills are desirable for many women, though it is also why estrogen-dominant women might choose a progesterone-only pill.

That being said…

The pill is complicated! In my personal experience, it’s just not worth it. But the negative health effects of the pill are all specific to the individual. As are the positive effects. And long term health impacts are not well-understood. For that reason, it is entirely specific to your body and your needs whether or not getting on a hormonal regimen is “worth it” for you.

As a final note…

As a result of the pill, women are excreting more hormones than usual, which are making their way into the water supply. This has significantly disrupted the reproductive cycles of some fish. It is also questionable how much these products make it into the water supply. Most studies seem to show that small percentages of it do (between ten and twenty percent), but that water treatment plants are mostly effective at filtering them out.

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What I listed above are well-known and popular effects of the pill. What was your experience? Did you have any side effects? Any unusual side effects? Let us know! The pill can do a whole lot more than it is commonly accounted for.

Starting this upcoming week, Paleo for Women is going to be embarking on Birth Control Week! Which will likely in fact last more than one week. Or one month. Did you know there are nearly two dozen different types of birth control?!

And we shall be talking about all of them!

September will be the month of Your Sex Life, Your Pleasure, Your Method. I want to help you find the most empowering, most healthful, and most delightful birth control method for you. This should be more than a bit of a blast.

Following this will be explorations of menopause and conception and pregnancy and breastfeeding, Oh. My.

Yes!

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Beforehand, I would like to “kick off” the birth control series by introducing and advocating to you the wonders of The Diva Cup, which is a an alternative to pads and tampons. Each of these methods have their own pluses and minuses, but in my opinion, the Diva Cup’s pros sometimes appear lifesaving and far outweigh it’s cons.

The Diva Cup is a small, bendy 1 oz. cup that you insert into your vagina to capture blood flow. It is uniquely designed to suction to the walls of your vagina, so 100 percent of the time it isinserted correctly it does not leak. Most women do not shed more than 4 oz of blood per menstrual cycle, so the cup does not need to be emptied all that often– for some women just at morning and at night.

To insert the cup, simply fold it in half (like so), wiggle it up there, and rotate it once or twice in order for the suction to take hold. If you tug on the bottom afterwards and it doesn’t move easily, then it’s suctioned.

To remove, really get your fingers up there, disrupt the suction around the sides, and pull out (keeping the cup vertical!).

Pull out the cup when you go to the bathroom, pour the blood out into a toilet or sink, and re-insert. Over time, you can probably learn how heavy your flow is at different times of your period, and learn how to time your Diva-emptying for optimal cleanliness.

Getting started

For women starting out on the Diva Cup, it might be wise to also wear pads while you get used to how the cup works. It takes a time or two, for example, before learning the difference between suction against the vaginal walls and just plain hanging out in there.

Moreover, I think most women on their first month of the Diva Cup go through an interesting and hopefully hilarious learning experience. I had more than one episode in a college library being stuck in a bathroom stall for fifteen minutes while yanking vociferously on that damned suctioned cup that just won’t budge, for example.

-You may spot a bit at the beginning as you learn the Diva Cup, but later will almost never leak

-So therefore it’s great for athletics

-There’s no string or bulkiness, so the Diva Cup makes bikinis and lingerie worry-free

–The Diva Cup sits high up against the cervix, so vaginal lubrication can still come through the vagina

–You can still have pleasurable and blood-free oral and manual sex!

In all cases, I recommend trying it. No harm, right?

So clearly I have a bias for the Diva Cup. I understand that not all women have the same experience, and I invite you to share your reasons and feelings about the Diva Cup below.

The reason personally that I love it so much is that it is empowering. More freedom, less fear of spotting and/or needing to change things. More benefits for the environment and your pocket. More intimacy with your own body. More pleasure. More sex. Huzzah! More life.

Have experiences, positive, negative, hilarious, mortifying, with the Diva Cup? Share in the comments! Would be an honor to hear them.

Episode Six of Live. Love. Eat. has now been posted. The powerful and wise mother behind the website Paleo Parents and the book Eat Like a Dinosaur: Recipes and Guidebook for Gluten Free Kids (with her husband Matt), Stacy, was my guest. In this episode, we talk about what it feels like to be discriminated against as an obese person, how weight loss is psychologically challenging even after the weight has come off, Stacy’s experience recovering from bulemia as a teenager, raising physiologically and psychologically healthy children, the impact of weight loss on love and intimacy, and why you might ever want to put photos of yourself in your underwear up on the internet (answer: empathy, courage, and inspiration.)

Each episode of Live. Love. Eat. is an interview with someone who has stepped up to share the story of her (or his) relationships with food and with her body. She may be a disordered eater, he may be a paleo dieter, she may be totally at peace with her body or not. The whole point being that I can do all of the writing on my blog here that I want, but I will never be able to do something as empowering, comforting, and inspiring as sharing with y’all the beautiful and brilliant lives of others.